What is a Nephrologist?

D. Jeffress

A nephrologist treats patients who suffer from diseases and disorders related to the kidneys, including kidney stones, renal failure, and blood pressure issues. A specialist diagnoses conditions by evaluating laboratory findings, diagnostic images, and symptoms. He or she then determines the best medications or other treatments to offer based on expert knowledge of pathology. Nephrologists work in many different health-care settings, including general hospitals, internal medicine specialty clinics, and joint and private practices.

Kidney disorders may require blood and urine testing.
Kidney disorders may require blood and urine testing.

Most people see nephrologists after being referred to them by their primary care physicians. When meeting with a new patient, a nephrologist reviews information provided by the referring doctor and conducts a detailed physical examination. He or she may decide to conduct diagnostic imaging tests or collect samples of blood, urine, or tissue for careful laboratory analysis. The doctor analyzes the results of diagnostic tests to confirm the presence of a particular disease.

Nephrologists often treat patients with recurring kidney stones.
Nephrologists often treat patients with recurring kidney stones.

Many acute and chronic conditions can affect kidney functioning. Specialists frequently treat patients with urinary tract infections, recurring kidney stones, renal inflammation, and hypertension. Dozens of other conditions that either cause or result from kidney problems are also confronted by nephrologists, including protein deficiencies, cancer, and inherited autoimmune disorders.

A nephrologist might oversee a patient's dialysis treatment.
A nephrologist might oversee a patient's dialysis treatment.

After making a diagnosis, a nephrologist might write a prescription or administer medications directly in his or her office. Some kidney problems necessitate very specific dietary and lifestyle choices to prevent complications, and a nephrologist can create specialized treatment regimens for his or her patients. Based on the nature and severity of a patient's problem, the doctor may schedule follow-up visits or recommend surgical care.

When a patient has a potentially fatal renal problem, the nephrologist makes the decision to initiate dialysis or arrange for a kidney transplantation. Some nephrologists, especially those who work in hospitals, attend surgical procedures to offer advice and assistance. Patients usually need to schedule frequent checkups with their nephrologists after receiving treatment to ensure their conditions have cleared up properly.

Nephrologists gain the knowledge and skills necessary to perform their jobs in medical school and residency training programs. After earning a doctor of medicine degree, a new professional typically enters a three-year internal medicine residency program at a hospital to gain formal training and experience under the guidance of established physicians. Following residency training, a doctor can enter a two- to three-year fellowship dedicated specifically to the practice of nephrology. A successful doctor can take an exam to earn board certification and begin practicing independently.

A nephrologist specializes in treating patients who suffer from various kidney disorders.
A nephrologist specializes in treating patients who suffer from various kidney disorders.

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Discussion Comments


I have had one kidney stone. It was big enough that I would never pass it, so I was referred to a urologist who blasted it and scoped the pieces out.

After blood work and a 24 hour urine collection she referred me to a nephrologist. He has not mentioned any type of kidney disease or failure, just the potential of a possible kidney stone in my future.

After only one kidney stone (I was 55 at the time), and only a potential of a possible recurrence, was a referral to the nephrologist necessary? I'm thinking about cancelling my next appointment.


I just refer to them as Kidney Doctors, but know they specialize in everything that has to do with your kidneys. Usually you don't have to find a doctor, because your regular doctor should refer you to a nephrologist if you are having problems.

Because they specialize in this and work with it all the time, they can get a clear picture of what is going on. My close friend has been on dialysis for several months and has spent much time with her nephrologist.


I have become very familiar with the topic in this article. I was having some routine blood work done and they discovered that my kidney functions were low. My urologist thought it was from a reaction to some medication I had been taking.

I was told to stop that and started something else that was supposed to improve my kidney function. You start to wonder after a while if the medications might do more harm than good sometimes - especially if you happen to have reactions to them.

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